Abstract:
BACKGROUND:The role of coagulase-negative staphylococci (CNS) in bacteremias continues to be controversial. Until the 1970s, CNS were mostly recognized as contaminants, being part of the cutaneous flora. Since then, several studies have reported increasing incidence and severity of infections due to CNS. PURPOSE:To review the literature concerning the epidemiology of CNS bacteremia in the United States and Europe with reference to the multiple definitions of infection versus contamination, considering the effect of potential biases influencing the validity of the reported results. METHODS:Literature search of the MEDLINE database from January 1980 to February 1998. Studies with fewer than 500 episodes of bloodstream infections or fewer than 100 episodes of CNS bacteremia were not included in the pooled analysis. RESULTS:(1) CNS remain the most frequent contaminants (58%-83% of positive blood cultures); (2) the proportion of all bloodstream infections caused by CNS is increasing (R=.51); (3) the overall incidence of true CNS bacteremia is increasing (R=.54, P=.0014); (4) comparing the United States to Europe, there is an increasing trend in the incidence of nosocomial bacteremia due to CNS in the United States (R=.82, P=.0006), but no trend is seen in European studies; (5) the mortality associated with true CNS bacteremia varies between 4.9% and 28%. DISCUSSION:This review confirms the increasing importance of CNS bacteremias, measured both as a proportion and as an incidence of bloodstream infections. The contributions of several possible explanations for the incidence increase and the difference between the United States and Europe need further evaluation: (1) increased recognition and awareness of CNS infections among clinicians; (2) a gradual change in the definition of true bacteremia from an obligatory two positive blood cultures to one positive blood culture associated with a clinical picture compatible with infection; (3) a change in blood culture practices and techniques; (4) an increase in the numbers of blood cultures performed, which is reported both in the United States and in Europe; (5) a shift toward more elderly patients with increasingly severe underlying illnesses; and (6) increasing use of intravascular devices. CONCLUSIONS:The apparent trend of increasing CNS bacteremia seems to be valid. Whether there is a real difference between the United States and Europe concerning the increase of CNS bacteremia is difficult to establish due to the large number of confounding factors. Few studies take into account the number of blood cultures performed or the use of intravascular devices to adjust for the observed trends. Further on-site surveillance studies are needed to investigate the phenomenon more extensively.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Thylefors JD,Harbarth S,Pittet Ddoi
10.1086/647878subject
Has Abstractpub_date
1998-08-01 00:00:00pages
581-9issue
8eissn
0899-823Xissn
1559-6834journal_volume
19pub_type
杂志文章,评审abstract::We present basic information that a hospital epidemiologist needs when designing a surveillance system for noninfectious adverse outcomes of care. Specific topics reflect key characteristics of such a surveillance system: the purpose, rationale, priorities, definitions, data collection tools, data collection, analysis...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647142
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVE:Molecular epidemiologic surveillance of Acinetobacter baumannii by polymerase chain reaction-randomly amplified polymorphic DNA analysis in a university hospital for 3 consecutive study periods. RESULTS:Twelve different Acinetobacter baumannii genotypes (A-L) were detected. Although only 2 genotypes were det...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/503349
更新日期:2006-04-01 00:00:00
abstract::Methodologies for evaluating the efficacy of antimicrobial agents in the bacterial flora of the hand involve variations of the "glove juice" or "sterile bag" procedures. In this study we demonstrate that the subungual flora contribute significantly to the recovery of bacteria in these procedures. Culturing hands that ...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章
doi:10.1086/645920
更新日期:1989-10-01 00:00:00
abstract:BACKGROUND:Treatment of Staphylococcus aureus colonization before surgery reduces risk of surgical site infection (SSI). The regimen of nasal mupirocin ointment and topical chlorhexidine gluconate is effective, but cost and patient compliance may be a barrier. Nasal povidone-iodine solution may provide an alternative t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1086/676872
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:To identify factors contributing to a cluster of deaths from invasive group A streptococcus (GAS) infection in a nursing home facility and to prevent additional cases. DESIGN:Outbreak investigation. SETTING:A 146-bed nursing home facility in northern Nevada. METHODS:We defined a case as the isolation of GA...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/508821
更新日期:2007-01-01 00:00:00
abstract::Methicillin-resistant Staphylococcus aureus (MRSA) has been notifiable in Western Australia since 1985. This article reviews the notification data from 1994 to 1997, focusing on increases in MRSA notifications and the proportion that are local strains; changes in the geographical distribution of MRSA; and changes in a...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501594
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVE:To determine trends, patient characteristics, and outcome of patients with healthcare-associated influenza in Canadian hospitals. DESIGN:Prospective surveillance of laboratory-confirmed influenza among hospitalized adults was conducted from 2006 to 2012. Adults with positive test results at or after admissio...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/674858
更新日期:2014-02-01 00:00:00
abstract::The technology of intravenous catheter access ports has evolved from open ports covered by removable caps to more-sophisticated, closed versions containing mechanical valves. We report a significant increase in catheter-related bloodstream infections after the introduction of a new needle-free positive-pressure mechan...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/499166
更新日期:2006-01-01 00:00:00
abstract::An outbreak of metallo-β-lactamase (MBL) producing Klebsiella pneumoniae occurred at a children's hospital in Japan. MBL-producing K. pneumoniae was detected in tea dispenser in the hospital, the use of which was associated with the acquisition of the MBL-producing Enterobacteriaceae. The outbreak ceased after use of ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.331
更新日期:2018-12-27 00:00:00
abstract:OBJECTIVES:To assess the ability of hospital air handling systems to filter Aspergillus, other fungi, and particles following the implosion of an adjacent building; to measure the quantity and persistence of airborne fungi and particles at varying distances during a building implosion; and to determine whether manipula...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502100
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:To screen copper and noncopper paints for their bactericidal effectiveness in rendering surfaces self-disinfecting. DESIGN:Tested paints were applied to glass coverslips, cured, inoculated with test organisms (Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Enterococcus faecalis), and dr...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/648361
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the clonality of methicillin-resistant Staphylococcus aureus (MRSA) strains among hospitalized patients. SETTING:University-affiliated, 465-bed tertiary-care teaching hospital with adjacent cancer clinic in Hamilton, Ontario, Canada. DESIGN:Thirty-five colonized and 30 infected patients from Jan...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647046
更新日期:1995-12-01 00:00:00
abstract::More than 90% of Thai hospitals surveyed reported implementing environmental cleaning and disinfection (ECD) protocols. Hospital epidemiologist presence was associated with the existence of an ECD checklist (P=.01) and of ECD auditing (P=.001), while good and excellent hospital administrative support were associated w...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.171
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:To determine the impact of the screening test, nursing workload, handwashing rates, and dependence of handwashing on risk level of patient visit on methicillin-resistant Staphylococcus aureus (MRSA) transmission among hospitalized patients. SETTING:General medical ward. METHODS:Monte Carlo simulation was us...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502589
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of a positive deviance strategy for the improvement of hand hygiene compliance in 2 adult step-down units. DESIGN:A 9-month, controlled trial comparing the effect of positive deviance on compliance with hand hygiene. SETTING:Two 20-bed step-down units at a tertiary care private...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/649224
更新日期:2010-01-01 00:00:00
abstract::We created a 2013 combination antibiogram of healthcare-associated urinary tract infection. The 2013 antibiogram-determined regimen was evaluated in a 2014 cohort who had received empirical therapy. The regimen was statistically more likely to represent adequate treatment than actual prescriptions. A customized antibi...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.108
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:To describe the characteristics of and trends in nosocomial infection among human immunodeficiency virus (HIV)-infected patients. DESIGN:Multicenter prospective cohort study. SETTING/PATIENTS:HIV-infected patients were enrolled at time of first inpatient admission at five Veterans' Administration Medical Ce...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/647652
更新日期:1997-07-01 00:00:00
abstract::OBJECTIVE Contaminated hands of healthcare workers (HCWs) are an important source of transmission of healthcare-associated infections. Alcohol-based hand sanitizers, while effective, do not provide sustained antimicrobial activity. The objective of this study was to compare the immediate and persistent activity of 2 h...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/ice.2017.293
更新日期:2018-03-01 00:00:00
abstract::During an insidious outbreak of salmonellosis in a long-term care facility, residents who were treated with acid-suppressing medications were 8 times more likely than other residents to develop Salmonella infection. Among vulnerable populations, the risks and benefits of acid-suppressing medications should be consider...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/520736
更新日期:2007-10-01 00:00:00
abstract::In 1997 the Association for Professionals in Infection Control and Epidemiology and the Society for Healthcare Epidemiology of America established a consensus panel to develop recommendations for optimal infrastructure and essential activities of infection control and epidemiology programs in out-of-hospital settings....
journal_title:Infection control and hospital epidemiology
pub_type: 共识发展会议,指南,杂志文章,评审
doi:10.1086/501569
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:To describe the identification, management, and clinical characteristics of hospitalized patients with influenza-like illness (ILI) during the peak period of activity of the 2009 pandemic strain of influenza A virus subtype H1N1 (2009 H1N1). DESIGN:Retrospective review of electronic medical records. PATIENT...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/661912
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Prepared ready-to-eat salads and ready-to-eat delicatessen-style meats present a high risk for Listeria contamination. Because no foodborne illness risk management guidelines exist specifically for US hospitals, a survey of New York City (NYC) hospitals was conducted to characterize policies a...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/658943
更新日期:2011-04-01 00:00:00
abstract::Micrococcus bacteria are frequently isolated from blood cultures and could represent a cause of infections associated with medical devices, particularly in immunocompromised patients; however, there is a lack of information on the management of micrococcal bacteremia. We report what is, to our knowledge, the largest s...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/592705
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Although many catheter-related bloodstream infections (CRBSIs) are preventable, measures to reduce these infections are not uniformly implemented. OBJECTIVE:To update an existing evidenced-based guideline that promotes strategies to prevent CRBSIs. DATA SOURCES:The MEDLINE database, conference proceedings,...
journal_title:Infection control and hospital epidemiology
pub_type: 指南,杂志文章
doi:10.1086/502007
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:To determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. PATIENTS:All patients at least 18 years of age...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.1344
更新日期:2020-12-17 00:00:00
abstract:OBJECTIVE:Ambulatory healthcare-associated infections (HAIs) occur frequently in children and are associated with morbidity. Less is known about ambulatory HAI costs. This study estimated additional costs associated with pediatric ambulatory central-line-associated bloodstream infections (CLABSIs), catheter-associated ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.305
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:To describe the prevalence, characteristics, and appropriateness of systemic antibiotic use in assisted living (AL) and to conduct a preliminary quality improvement intervention trial to reduce inappropriate prescribing. DESIGN:Pre-post study, with a 13-month intervention period. SETTING:Four AL communities...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/677821
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVES:To compare the cost of hospitalization of patients with methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) versus patients with methicillin-sensitive S. aureus (MSSA) BSI, controlling for severity of underlying illness; and to identify risk factors associated with MRSA BSI. DESIG...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502417
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVE:In-hospital transmission of methicillin-susceptible Staphylococcus aureus (MSSA) among neonates remains enigmatic. We describe the epidemiology of MSSA colonization and infection in a 30-bed neonatal ward. DESIGN:Multimodal outbreak investigation SETTING:A public 800-bed tertiary care university hospital in...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2015.184
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the cost-effectiveness of a dual strategy of tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT-G) for screening of latent tuberculosis infection (LTBI) in healthcare workers (HCWs) and, as a secondary objective, to study relationships between TST results, QFT-G results, and sociodemographic ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/668436
更新日期:2012-12-01 00:00:00